Praktikum Resep

1

Dokter Hasan SadikinJl. Pasteur No.31 Telp. 59710 Bandung

SIP No. 01/KW/1987

No. Bdg.Tgl

R/ Bacitracin Neomycin Ung 10 Polimyxin B.Sulfas 5 mg/g

Mds 3 dd ue

Pro :SugihartoUmur/Berat Badan :Alamat :

Dokter Tjipto MangoenkoesoemaJl. Pasteur No.31 Telp. 59710 Bandung

SIP No. 02/KW/1987

No. Bdg.Tgl

R/ Phenobarbital 0,6 Nat.Bromid 2 Aq.menthe.Pip

S 3 dd C1

Pro :SugiyonoUmur/Berat Badan :Alamat :

Dokter M. SalamoenJl. Pasteur No.31 Telp. 59710 Bandung

SIP No. 03/KW/1987

No. Bdg.Tgl

R/ Paracetamol 0,25 Aspirin 0,25 Coffein 0,065

M,f caps dtd No.XS bila pusing/sakit kepala Caps I

Pro :Suharto, SHUmur/Berat Badan :Alamat :

PUSAT KESEHATAN MASYARAKATKecamatan : RancabadakKotamadya : Bandung

No. Bdg.Tgl

R/ Gentamycin 0,3 % Hidrocortison 3 %

m.f Ung 20

Pro :BagusUmur/Berat Badan :Alamat :

2


SIP No. 01/KW/1987

No. Bdg.Tgl

R/ Teosal 2/3 tab Ephedrin 30 mg Prednison 2,5 mg

m.f l.a caps dtd no VI

Pro :Ny.FeliciaUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/ Adeps Lanae 1 Vas.album 2 Bolus Alba 20 Zn, Oxyd 4 Talc.Venet 4 Ol.Rosae qs

m.f. pulv adsp

Pro :CeciliaUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/ Syr thymi comp 120 ml Limunal 200 mg Paracetamol 1 g

Mds 3 dd cth 1

Pro : SusianiUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/ Neomicin SO4 2 % Benzocain 2,5 % Adeps Lanae Vaselin Flav aa ad 15

m.f la ungt S.ue

Pro :MargiUmur/Berat Badan : 6 tahunAlamat :

3


SIP No. 01/KW/1987

No. Bdg.Tgl

R/ Phenobarbital 10 g Benostan 1/5 tab Salbutamol 1,0 mg SL qs

m.f pulv dtd X

Pro : ElshadaiUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/ Acid salicyl 7,5 Balsam peru 0,5 Adeps Lanae 0,75 Mg.O Zn.O aa 8 Talc ad 40

m.f pulv adsp S. bedak

Pro :Umur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Paraffin liq 7,5PGA 9,5Bellad extr 0,05Sirupus citri 10Aqua ad 100

m.f potioS 2dd CI

Pro : Umur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Salep benzocain 15AddeCortison

Mds 3 ue

Pro : HerlambangUmur/Berat Badan :Alamat :

4


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Chlorampenicol 125 mgBellad Extr 5 mgBiogsoc 125 mgSVCS qs

m.f pulv dtd no XII



SIP No. 02/KW/1987

No. Bdg.Tgl

R/Chlorampenicol 2 %Hydrocortison 2,5 %Mentholum 0,5Emulgide cream 15 % ad 15

m.fla ungt S.u.e



SIP No. 03/KW/1987

No. Bdg.Tgl

R/Phenobarbital 0,5Kloralhidras 1Ol.Menthae pip gtt IISirupus citri 15Aqua ad 100

m.f potioS 2 dd C I

Pro : irawatiUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Menthol 0,05Acid salicyl 1Zn.O 20Mg.O 20Talk venet 100

m.f 50

Pro :KiaritaUmur/Berat Badan :Alamat :

5


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Bismuth Sub Nitrat 1,0Tinct opii Aromatic 4,0Sir Simplex 10

m.f potio 60 S.3 dd Cth I

Pro : Bayu SUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Tab.Rimactane 450 gTab.Pehadixin Forte aa ½ Tab

m.f pulv dtd No.XXXS 1 dd pulv 1 ½ h ac

Pro : BudimanUmur/Berat Badan : 30 kgAlamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Salep 4-5 15AddeNeomisin 2 %Champor 1 %

Mds.ue

Pro : RafiUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Dipenhyramin HCL 80 mgAethanol 90 % 7 mlSir Simplex 10 %Olei M P gtt I

m.f eliksir 100 mld.s 3-4 dd Cth I


6


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Salep Wasir 20AddeBalsam Peru 5 %

Mds.Obat wasir

Pro : Tn.RobertUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Tetes hidung Antazoline 20 ml

Pro : MungriUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Potio nigra 100 mlAddeCodein HCL 0,10 %

Mds 3 dd C I

Pro : Ir.SusantoUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Fenilbutazon 0,100Vit B1 0,050Asetaminophen 0,350

m.f cap dtd No X

Pro :NanangUmur/Berat Badan : 60 kgAlamat :

7


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Ol.Iecoris Aselli 5Cera flava 0,5Chloramp 2 %Vas.Flav Ad 20

m.f.ungtS.Obat luka bakar

Pro : Oom KUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Paracetamol 1,5Efedrin HCL 0,2CTM 0,05Sir Simplek 15

m.f Potio 60 mlS 3 dd Cth I

Pro : MarlinaUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Syr.DMP 100 mlContinPrometazine HCL 15mg/ml

Mds 3 dd C I

Pro : Dra. HanifahUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Ac. SalicylAc. Benzoic aa 2 %Iodium 0,50 %Ethanol 70 % ad 100 ml

Mds.Obat Panu

Pro : WawangUmur/Berat Badan :Alamat :

8


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Lidocain 5 %Hydrocort.Acet 0,075Sulfur 2,50 %Adeps LanaeVas.Flav aa 20

S. obat wasir

Pro : SutedjaUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Cap.Amobiotic I capThiamin.HCL 0,100Phenobarbital 0,050

m.f Captd No.XII

Pro : LiliUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Syr DMP 100 mlContinPrometazina.HCL 15mg/5ml

Mds 3 dd C I

Pro : Dra.hanifahUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Ac.SalycilAcBenzoic aa 2 %Iodium0,50 %Ethanol 70 % a 100 ml

Mds. Obat Panu

Pro : WawangUmur/Berat Badan :Alamat :

9


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Tab.Sanprima Forte ½ tabKlordiazepoxid 0,05Paracetamol 0,5

m.f pulv dtd no XII

Pro :TukulUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Dionin 0,5 %Dextromethrophan 0,2 %OBH 50Aq Dest ad 150

ds. Obat batuk.3.ddc

Pro : ReginaUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/ Tannin 0,75Paraff. Liqq 1,5Cetyl Alcohol 0,75Adeps lanae 1,75Vaselin Alb ad 15

S 3 dd u.e

Pro : Agung Umur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Mehyl salycilas 25 mlMethol 4Ol. Eucalypti 10 mlOl. Arachidis ad 100 ml

Mf. LinimentS 2.dd u.e

da 1/5 part

Pro : bachtiar HUmur/Berat Badan :Alamat :

10


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Cendofenicol gutt 10 mlAuricContinPolimyxin B sulfas 3 mg/ mlLidocain cl 0,04/ml

Mds. 4 dd gtt II ads

Pro : SusantiUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Cetaceum 12,5Cera Flava 12Paraffin liq. 56Nat. tetraboras 0,5Aqua 19 ml

Mds. 3dd. UeDa 1/5 part

Pro : yeyen Umur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Tab. Broxal 1 tabGlyceril guaiacolas 0,1Efeedrin Hcl 0,0125

Mf. Caps dtd No XS. bila sesak Caps I

Pro : Drs. zaenalUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Dionin o,o6Tct. Belladon 6S.a.s.a 6Syr. Thyme 30

Mf. PotioS 3 dd Cth II

Pro : Yusuf (15 thn)Umur/Berat Badan :Alamat :

11


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Potio Nigra 200 ccCodein HCL 200 mgOl.Menthae Pip gtt II

Mds 3d C I

Pro : FrediUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Kalii iodida 2Cera flava 3Ol.Sesami 3Lanolin 10

m.f. la Ungt

Pro : KardinahUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Aminophilin 75 mgCohistan.tab 1/2Mucopect.tab 1/2Vit B1 25

S 2 dd caps I pc

Pro : FanyUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Calamin 10 %Bentonit qsOl.rosae 0,01 %Alkohol dil. 3,0 mlAqua ad 60 ml

m.f Potio

Pro : SteviaUmur/Berat Badan :Alamat :

12


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Pyrazinamid 200 mgRifampicin 100 mgINH 100 mgVit B6 5 mgSL qs

m.f pulv XII



SIP No. 02/KW/1987

No. Bdg.Tgl

R/Oxy Tertasiklin 2 %Ichtamolum 2 %Vaselin flav ad 10

m.f la ungtSalep Bisul

Pro : GugunUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Theophilin 1Codein HCL VPamol tab IIISyr. Thymi 20Aqua ad 100 ml

m.f potioS 3 dd C I

Pro : JacklinUmur/Berat Badan : 8 thnAlamat :


No. Bdg.Tgl

R/Neomisin SO4 500 mgCocain HCL 3 %

m.f gutt II Auric


13


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Bactrim Forte.tab VIIPapav HCLParasetamol aa 1,2

m.f pulv No.XIIS.o.8.h pulv I

Pro : SudomoUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Oxytetracyclin HCL 3 %Hidrocort-aset 2,5 %Salep 4-8 20

m.f UngtS . Salep Gatal

Pro : PungkiUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Ephed.HCL 0,1Parasetamol 1CTM 0,05Sir.Simplek 15

m.f PotioS 3 dd Cth I

Pro : ClarisaUmur/Berat Badan :12 thnAlamat :


No. Bdg.Tgl

R/AmylumZn.O aa 5 %Ac.Salicylat 2 %Talc ad 20

S.3 dd u.e


14


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Epexol.tab IGG 0,1Ephedrin HCL 0,0125

m.f caps dtd No X

S. bila sesak nafas caps I



SIP No. 02/KW/1987

No. Bdg.Tgl

R/Tetracyclin HCL 2%Hidrocortison Acetas 2,5 %Lanolin 4Vas.Flav 10

m.f la Ungt S.u.e

Pro : SisingamangarajaUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Aminophylin 200mgEphedrin HCL 20 mgSir.simplek 20Ethanol 6 % RP 10 mlAqua ad 100

m.f la poioS tdd C I

Pro : FirmantoUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Peru Balsam 2 %Menthol 0,5 %Champorae 0,5 %Ac.salicyl 1 %Talc ad 20

Mds . Obat Gatal


15


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Extra.Bellad 0,075HCL Codein 0,300HCL Ephedrin 0,400Luminal Na 0,300Sir.Strichni 100 mlAqua ad 300

did

Mds 3 dd C

Pro : AnandaUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Tab.neosanmag XIDiazepam 0,05

M.f pulv No XII

Pro : SelomitaUmur/Berat Badan :48 kgAlamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Ungt.WhiteField 15AddeSulfur PP 3 %

Mds.Ungt



No. Bdg.Tgl

R/Diphenhidramin HCL 1 %Calamin 8 %Camphora 0,10 %

m.f Lotio S.u.e

Pro : wanandiUmur/Berat Badan :Alamat :

16


SIP No. 01/KW/1987

No. Bdg.Tgl

R/ Codein Hcl 0.01 CTM 0.004 Bromhexin 0.008 Paracetamol 0.250

m.f caps dtd no X

S.3dd caps I

Pro : MargieUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/ Sol Campora Spirit 10 Acid salicyl 1 Zn Oxyd 1 Vaselin ad 20

m.f ungt sue

Pro : RatnaUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/ Syr GG 125 mlContinTheophylin per cth 0.05

m.f la potioS 5ml-0-5ml

Pro : NuritaUmur/Berat Badan : 6 thnAlamat :


No. Bdg.Tgl

R/ Antazolin HCl 0.100Procain HCl 3%

m.f Gutt auric

Pro : HerlinaUmur/Berat Badan :Alamat :

17


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Doveri tab No III Ephedrin HCl 0.2 Kalii Iodida 2 Ol Menthae Pip gtt I PGS 2% Aqua ad 100 m.f la potio

Pro : AdrianusUmur/Berat Badan : 8 thnAlamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Tetrasiklin HCl 2% Benzocain 3% Ng Simplex ad 15

m.f UngtSue

Pro : DoritaUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/ Allopurinol 100 mgNa Diklofenak 25 mgVit B6 25 mg

m.f. la Caps dtd no XS 3 dd Caps I

Pro : NurmalitaUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/ Acid salicyl 1%Glycerin 3Etanol dil ad 60

Mds Obat Panu

Pro : KarlinaUmur/Berat Badan :Alamat :

18


SIP No. 01/KW/1987

No. Bdg.Tgl

R/ Asmadex 1/3 TabPrednison 2,5 mgEphedrin HCl 12,5 mg

m.f la caps dtd no XIIS3 dd Caps I

Did –

Pro : ZulaehaUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/ Peru Balsam 2%Menthol 0.5%Camphora 0.5%Acid Salicyl 1%Talc ad 20

m.ds obat gatal

Pro : JunaediUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/ Aminophilin 200mgEphedrin Hcl 20mgSyr Simplex 20Etanol 6% RP 10mlAqua ad 100

m.f la PotioStddCI

Pro : FirmantoUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/ Salep Whitefield 15AddeSulpur PP 3%

m.d.s Ungt

Pro : DodyUmur/Berat Badan :Alamat :

19


SIP No. 01/KW/1987

No. Bdg.Tgl

R/ Diphenhidramin HCl 0.3Amonium clorid 2.5Natri.Citrat 1.1Menthol 0.02Alkohol 5%

m.f PotioS 3 dd I

Pro : FaridaUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/ Pyridoxin HCl 100mgCholfeniramin maleat 5mgAmoxillin 250 mgBiogesic 350 mgSacharum lactis qs

m.f.pulv dtd no XS3ddpI

Pro : DahliaUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/ Salep sejuk

Pro : LannyUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Ac SalicylAc Benzoic aa 2%Iodium 0.5%Ethanol dil ad 20ml

Mds obat panu

Pro : HasanUmur/Berat Badan :Alamat :

20


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Tab alludona no XVAddeAtropine SO4 0.2

m.f.pulv no XIIS 3 dd pulv I

Pro : MaduUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Anaestesin 2%Acid Salicyl 1Mentholum 6Ung Simplex ad 15

m.f la ungtsue

Pro : RamaUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Ammonium Chlorid 0.3Succus liq 0.35Codein HCl 0.12Ol menth pip gtt II

m.f PotioS3ddCI

Pro : Tn NandangUmur/Berat Badan : 60 Kg

Alamat :


No. Bdg.Tgl

R/Diphenhidramin HCl 1%Calamine 8%Campora 0.1%

m.f Lotio 60 mlSue

Pro : NobitaUmur/Berat Badan :Alamat :

21


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Acetaminophen 250 mgHCl Codein 10 mgOcuson ½ Tab

m.f Caps dtd no XIIS pc

Pro : Tn DavidUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Flores Zinci 1Ichtamolum 0.5Ungt 2-4Lanolin aa 10

m.f la UngtSue

Pro : MardianiUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Doveri 0.15Ephedrin HCl 0.2Kalii Iodida 2Ol mentae Pip gtt 1PGS 2%Aqua ad 100

m.f la Potio

Pro : TasyaUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Tetes Telinga H2O2 20 mlContinAcid Boric 1%

S q gtt I

Pro : MawarUmur/Berat Badan :Alamat :

22


SIP No. 01/KW/1987

No. Bdg.Tgl

R/HCl Codein 0.3HCl ephedrine 0.4Phenobarbital 0.3Syr Thymi 100Aqua ad 200

m.d.s 3 dd C I- did -



SIP No. 02/KW/1987

No. Bdg.Tgl

R/Oxy tetrasiklin 2%Ichtamolum 2%Vaselin flavumad 10

m.f la ungt

Pro : SuneoUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Luminal tab IIDilantin 0.2Paracetamol 200 mg

m.f pulv dtd no X da in capsS 2 dd I caps

Pro : MurniUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Acid salic 2%Sulpur 1%Campora 0.5%Balsam peru 600mgBolus Alba 4Talkum ad 20

m.f pulv adsp

Pro : YohaniUmur/Berat Badan :Alamat :

23


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Acetosal 0.250Coffein 0.150Aneurin HCl 0.06Elaeosac anisi qs



SIP No. 02/KW/1987

No. Bdg.Tgl

R/Chloramfenicol 2%Hydrocortisone 2.5%Mentholum 0.5%Emulgide cream 15 % 15

m.f la ungtSue

Pro : JoniUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Extr belladHCl codein aa 0.3HCl ephedrine 0.4Syr Thymi 100Aqua ad 200

Mds 3 dd CIDid -

Pro : Ny SusanaUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Ac undeylenic 1Zn undecylenas 5Talc Venet 18Kaolin 26

Mf pulv adspsue

Pro : BonitaUmur/Berat Badan :Alamat :

24


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Metronidazole 0.5Extr belladon 0.01Tinct Hyosciamin 0.250

m.f pulv dtd no XIIS 3 dd I pulv

Pro : Ny SaodahUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Asam asetil salisilat 0.1Opii pulvis Comp 0.075

m.f pulv dtd no XIIS 3 dd I Caps

Did –

Pro : MarlinaUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Salep ikamycetin 15AddeHydrcort acet 10 mg/gram

Mds ungt

Pro : Karsono SHUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Phenol liq 0.5MentolCampor aa 0.2Tinct Aurantii 15%

Mds gargarisma 120 ml

Pro : FreetyUmur/Berat Badan :Alamat :

25


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Acetosal 0.250Coffein 0.150Aneurin HCl 0.06Elaeosac anisi qs



SIP No. 02/KW/1987

No. Bdg.Tgl

R/Chloramfenicol 2%Hydrocortisone 2.5%Mentholum 0.5%Emulgide cream 15 % 15

m.f la ungtSue

Pro : JoniUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Extr belladHCl codein aa 0.3HCl ephedrine 0.4Syr Thymi 100Aqua ad 200

Mds 3 dd CIDid -

Pro : Ny SusanaUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Adeps lanae 1Vasel album 2Bolus alba 20Zn Oxyd 4Talc venet 4Ol rosae qs

m.f pulv adsp

Pro : cecilliaUmur/Berat Badan :Alamat :

26


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Codein HCl 10 mgAsam mefenamat 200 mgDiazepam 5 mg

m.f caps dtd no XXXS 3 dd caps I

Did –

Pro : AstutiUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Lidocain HCl 5%Hydrocort Acet 0.075Sulfur 2.5 %Adeps lanaeVasel flav aa 20

S obat wasir

Pro :Tn koko RobUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Diphenhidramin HCl 0.6Ammonium chloride 3Na Citrat 2Alcohol 2%

m.f potio 200 ml

Pro : Ny AminahUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Ac undeylenic 1Zn undecylenas 5Talc Venet 18Kaolin 26

Mf pulv adspsue

Pro : BonitaUmur/Berat Badan :Alamat :

27


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Acid salic 2%Bals peru 2%Magn Oxyd 10 %Zn Oxyd 10 %Talcumad 25

m.f pulv adsp

Pro : armetUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Chloramfenicol 125 mgBellad extr 5 mgPamol 150 mgLactosum qs

m.f la pulv dtd no XS 3 dd p I

Pro : AmbarUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Ol sesame 12Vit E 0.25Ol foenic 0.4Syr simplex qsm.f emulsi 125 ml

S 5 ml - 0 – 5 ml

Pro : MaddonaUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Antazoline HCl 0.100Procain HCl 3%

m.f gutt auric


28


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Antazolin HCl 0.5%Naphazol HCl 0.05%Sol glucose 5% ad 20 ml

m.f gutt nasalsS 2 dd gtt III

Pro : M ikhsanUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Aflucaps caps no XPro caps sing addeVit C 125 mgNa sulfas 120

m.f pulv da in capsS t id I pc

Pro : CindyUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Salep 2 – 4 15AddeNeomisin 2%Campor 1%

Mds ue

Pro : Rafi ahmadUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Diphenhidramin HCl 80 mgAethanol 90 % 7 mlSyr Simplex 10 %Ol Menth Pip gtt I

m.f elixir 100 mld.s 3 – 4 dd cth I

Pro : SintaUmur/Berat Badan :Alamat :

29


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Tetes Telinga H2O2 20 mlContinAcid Boric 1%

S q gtt I

Pro : BobohoUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Bactrim Tab 1 TabPapav Hcl 0.03

m.f pulv dtd no XIIS O 8 h pulv I

Pro : Ria irawanUmur/Berat Badan : 48 kgAlamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Sir Neomiysin 100AddeExtr hyosciamin 0.05/cth

Mds 3 dd cth II

Pro : YusufUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Chloram palmitat 3%Prednisolon 0.1Paraf liq 2Vasel flav 20

S 3 dd ue

Pro : akbar tanjungUmur/Berat Badan :Alamat :

30


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Zin chlorideAluin aa 1Acid salyc 0.3Ol mp gtt IIAqua ad 300

Mf ds gargDid -

Pro : SungutUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Piroksikam 10 mgCalcii lactase 100 mgVit B6 10 mgVit B1 50 mg

m.f la caps dtd no XS m et vesp

Pro : Tn SoehartoUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Kalii iodide 0.3Papav HCl 0.4Bellad tab IVPGS 2%Aqua ad 100

m.f potioS t dd cth I

Pro : MerianaUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Tetrasiklin HCl 2%Hydrocort acet 2.5 %Lanolin 4 Vasel flav ad 20

m.f la ungtsue

Pro : AndreeUmur/Berat Badan :Alamat :

31


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Amokilin trihidrat 250 mgMeprobamat 125 mgMetamizol 300 mgTrimetilxantin 25 mgSL qs

m.f caps dtd no XS.sns I pc ( dihabiskan)

Pro : Tn sastrawijayaUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Syr INH 120 ml

S 4 dd 10 ml

Pro : MinatiUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Phenol 0.3Ol MP gtt IIMenthol 0.2Tc Aurantii 10 ml

m.f CollutioSuc

Pro : FredawatiUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Salep wasir 15

Mds suo nom

Pro : KristinaUmur/Berat Badan :Alamat :

32


SIP No. 01/KW/1987

No. Bdg.Tgl

R/SD 5Ol olivae 15Luminal 0.5Syr cinamom 20

m.f emulsi 200S O 8 h cth II

Da ½ part –

Pro : Dedy SUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Salep whitefield 15AddeSulfur PP 3%

Mds ungt

Pro : DodyUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Tab Hedix No VIIIAdde pro doseThiamine HCl 0.01

m.f pulv no XIIS 3 dd pulv I

Pro :SilviaUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Neomicin 3.5/gZn bacitracin 5 mgTalk ad 10

m.f pulv adsp sterilda in sachS 3 dd ue

Pro : KristinaUmur/Berat Badan :Alamat :

33


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Miconazol No 3 2%Hydrocort acet 1%

m.f cream 10s 2 dd ue

Pro : SobirinUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Tab neo sanmag no XVDiazepam 0.05

m.f pulv no XIIS 1-1-1

Pro : Soleh Umur/Berat Badan : 42 kgAlamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Syr GG 100 mlAddeTheopilin 1.2Diphenhidramin HCl 0.25

Mds 3 dd cth I

Pro : AnandaUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Diphenhidramin HCl 1%Calamine 8%Campora 0.1%

m.f lotiosue

Pro : SopyanUmur/Berat Badan :Alamat :

34


SIP No. 01/KW/1987

No. Bdg.Tgl

R/(Salinan Resep) iter IXCorsanural no XAdde pdsTrimetilxantin 25 mgm.f capsS 0 6-8 h I

Det IX

Pro : Ny sintabelaUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Sulfadiazine 100mg/cthNatri bic qsKalii bromide 0.6Sir thymi 15%

m.f potio 60 mlS 3 dd cth I

Pro : MardiantoUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Tetes Telinga H2O2 20 ml

Mds sns gtt I-II

Pro : FatimahUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Parafin LiqGMS aa 15Na laurel sulfas 3Aqua des 67Parfum qs

m.f creamsuc

Da 20 gram –

Pro : KartiniUmur/Berat Badan :Alamat :

35


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Fluxol Forte 3/5 tabDextrometropan HBr 15 mg

m.f pulv dtd no XIIS Obat demam

Pro : Ny krisdayantiUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Ol anisi 100 mgCampora 500 mgAcid benzoic 500 mgTct Opii 3

Mds in caps no XS 3 dd cap I

Pro : Tukul Umur/Berat Badan : 16 thn

Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Linimen benzyl benzoas s.f

S us not

Pro : Andy noyaUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Ol caryopili 2%Ol Cajuputi 5%Campora 5%Paraffin 20%Vasel flav ad 20

Mds gosokan bila perlu

Pro : kelikUmur/Berat Badan :Alamat :

36


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Tab Doveri no XIIPro dose addeVit B 12 5 mgCoffein 40 mgLuminal 10 mgSVCS qs

m.f pulv

Pro : Ny larasatiUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Fe Lactas 0.4Acid citri 0.5Arsen trioxide 0.015

m.f potio 60 mlS t dd cth I

Pro : MurniwatiUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Losio hidrokotison-neomisin

100ml

SueDet 80 ml

Pro : FeronikaUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Menthol 0.05Acud salic 1ZnO 20MgO 20Talk Venet 100

m.f 50

Pro : KlaritaUmur/Berat Badan :Alamat :

37


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Acid salicyl 2Acid benzoic 2Adeps lanae 4MgO 10ZnO 10

m.f pulv adsp 100s 3 dd ue da 50

Pro : HerryUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Tab sanprima 1 TabPapav HCl 0.03

m.f pulv dtd no XIIs o8 h pulv I

Pro : Ria irawanUmur/Berat Badan : 48 kgAlamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Sir neomisin 100AddeExt hyosciamin 0.05/cth

Mds 3 dd cth II

Pro : yusufUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Chloram Palm 3%Prednisolon 0.1Paraf liq 1Vasel flav 10

S 3 dd ue

Pro : akbar tanjungUmur/Berat Badan :Alamat :

38


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Na Lauril sulfas 0.3Propylenglicol 3.6Cetyl alcohol 7.2Vaselin 8.4Aqua dest ad 30Neomisin 210 mg

Mds krim obat

Pro : Ny silviaUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Sir neomisin 60 mlContinTict bellad 2Diazepam 1

Ds o 5 h cth I

Pro : BillyUmur/Berat Badan : 10 thn

Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Acid salicyl 0.5Adeps lanae 1.0MgO 2.5Talk ad 20

Mds pulv ads

Pro : Om FarhanUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Sanmag No VIIIExtr hyosciam 0.6Papav HCl 0.48

m.f pulv No XIIS 3 dd p I dc

Pro : si butet jogjaUmur/Berat Badan :Alamat :

39


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Bismuth sub nitras 1TOA 4Sir simplex 10

m.f potio 60s 3 dd cth I

Pro : Bayu SUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/ Tab rimactane 450mgPehadoxin Forte tab ½ tab

m.f pulv dtd no XXXS 1 dd pulv I . ½ h ac

Pro : budimanUmur/Berat Badan : 30 kgAlamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/As borat 1.5Sulpur pp 0.4Zink oxyd 3Talk 3Etanol 8 ml

m.f lotio 50 mls 33 dd ue

Pro : Anna TUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Gentamicin 0.5%Hidrokortison 3%

m.f ungt 10

Pro : BagusUmur/Berat Badan :Alamat :

40


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Hydrocor acet 2%Neomisin 0.0035/g

m.f cream 15s 3 dd ue

Pro : kiwilUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Diphenhidrain HCl 2%Calamine 8%Campora 0.1%

m.f lotio 100 mls 3 dd ue

Pro : ari wibowoUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Phenyleprine HCl 50 mgNa pyrosulfit 20 mgProlylenglicol 1 mlSol pisiologis ad 20 ml

m.f la gtt nasalS 3 dd gtt II

Pro : BarqouiUmur/Berat Badan : 16 thAlamat :


No. Bdg.Tgl

R/Tab cotrim adult 1 tabPapav HCl 0.015Mg carbonas 0.3

m.f pulv dtd no XIIs o 8 h pulv I

Pro : ny ayu azhariUmur/Berat Badan :Alamat :

41


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Serbuk bagi acidov III No XIIPds addeMebhidrolin napadisilat 50mgVit B2 30mgSVCS qs

Mf pulv No XstddI dc

Pro : dr sumintoUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/OBH duplex 90mlContin per cthDionin 5mg

S3dd cth II

Pro : tn mardiyunaUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Benzyl benzoas 15Parafin cair 5Asam stearat 10Span 60 7Tween 60 3Air 60

Mds liniment da1/2part

Pro : FerawatiUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Chlorampenicol 20mg/gCortisone acet 2%Acid salyc 1%

m.f ung 10sue

Pro : kadrawatiUmur/Berat Badan :Alamat :

42


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Amoksilin trihidrat 250mgMeprobamat 125mgMetamizol 300mgTrimetilxantin 25mgSL qs

Mf caps dtd No XS.sns Ipc

Pro : Tn SastraUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Sirup INH 120ml

S 4dd 10 ml

Pro : MinantiUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Loco. Bedak Purol 20

ds. pulv. ads pers.dipakai setelah mandi

Pro : Ny RinaUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Benzocain 2 %Erythromycin 2 %Cream base ad 20

m. f. cream.S. ue.

Pro : SusanUmur/Berat Badan :Alamat :

43


SIP No. 01/KW/1987

No. Bdg.Tgl

R/TOB. 1,5Tct. Digitalis 0,5Sorbitol sol. 70% ad. 20m. f. PotioS. 3 dd. gtt. XXX

Pro : YogiUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Calamin lotion 50Lact. sulfurGlycerin aa. 10 %Bentonit q. s.

Mds. lotion.

Pro : Ny FeniUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Gentamycin 0,002 /g Cortison acet. 1 %

m. f. l. a. creamS. 2 dd. applic

.

Pro : Ny CessiUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Doveri tab. ISalicylamid 0,200Menthol 0,025Elaeos. Citri q. s.m. f. pulv. dtd. No. XII

S. 3 dd. p. I

Pro : SugiartoUmur/Berat Badan :Alamat :

44


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Digitoxin 50 mcg

Quinidin sulfat 0,100 m. f. l. a. pulv. dtd. No. XII

ds. prn. p. I.

Pro : TatyUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Camphor 0,100Na. Subcarbonat.Na. CitratNa. Chlorid. aaa. 3Aqua ad. 100 ml.

Mds. Collunarium

Pro : TantyUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Diphenhydr. HCl. Elixir 60 ml. DXM 0,100Codein HCl 0,150

m. f. pot. 100 ml.ds. o.6 h. cth. I

Pro : Titi DJUmur/Berat Badan :Alamat :


No. Bdg.Tgl

R/Amyl. Manihot 5Glycerol. 25Zinc. oxyd.Ichtamol aa. 2,5

m. f.ungt. sue

Pro : TantriUmur/Berat Badan :Alamat :

45


SIP No. 01/KW/1987

No. Bdg.Tgl

R/Neomycin 0,140Lidocain HCl 1% m. f. gtt. auric. 20 ml.

S. 3 dd. gtt. I-II

Pro : PudjiUmur/Berat Badan :Alamat :


SIP No. 02/KW/1987

No. Bdg.Tgl

R/Salep 3 - 8 15adde.Cortison acet. 1 %Camphor 2 %mds. ue.

Pro : YohanaUmur/Berat Badan :Alamat :


SIP No. 03/KW/1987

No. Bdg.Tgl

R/Tab. Acidov. II No. VI.CTM tab. No. IV

m. f. pulv. No. Xds. prn. 3 dd. p. I.



No. Bdg.Tgl

R/Pot.Nigra 50

ml. Contin.Chloramphenicol 0,125 /

cthLuminal 0,010 / cth

ds. o. 6. h. Cth. I


46


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


47


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


48


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


49


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


50


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


51


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


52


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


53


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


54


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


55


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


56


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


57


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


58


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


59


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


60


SIP No. 01/KW/1987

No. Bdg.Tgl

R/



SIP No. 02/KW/1987

No. Bdg.Tgl

R/



SIP No. 03/KW/1987

No. Bdg.Tgl

R/



No. Bdg.Tgl

R/


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